Primary Care

Your subscription to modernized medical care.

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Primary Care Services

Your subscription to modernized medical care.

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Boston Primary Care Physicians

Your Primary Care Partners

Take back control of your medical care, by working directly with your Primary Care Physician in Boston without insurance impeding the healthcare and wellness services you deserve.

Boston Direct Health modernizes primary care by utilizing the Direct Primary Care (DPC) model. DPC medical practices have a monthly subscription providing access to the Boston Direct Health’s medical team. The monthly fee covers all the medical visits at the practice whether you are coming in for preventative visits, nutritional counseling, management of high blood pressure or diabetes, management of sick visits, or urgent care needs.
Patients have the option to conveniently communicate with their doctors and the health care team through text, phone calls, emails and secure portal messaging. Messages are responded to in a timely manner. You are able to communicate with YOUR doctor 24/7.
Medication refill requests are typically completed within a day or two. With our boutique doctor style direct primary care services we eliminate the hassle of extensive waiting time for refill scripts.

Boston Direct Health still works in conjunction with your health insurance. The difference is we don’t bill health insurance for your care visits. There are no surprise bills from our medical practice, no co-payments, and no need to worry about deductibles.

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This is how Boston Direct Health differs from typical concierge medicine doctors in the Boston, Massachusetts area. Most concierge doctors charge a monthly or yearly fee to provide access to their medical practice and the doctors but they still bill the health insurance of their members.
Unlike these other concierge doctor businesses, at Boston Direct Health we avoid surprising our patients with unforeseen costs such as co-pays and bills for medical visits. Health insurance can still be used to cover prescription medications, lab work, imaging studies such as XRays and MRIs, and referrals to specialists.
It’s like changing health insurance into car insurance. With car insurance, you pay out of pocket to keep your car running, paying for the gas, oil changes, yearly maintenance tests, but keep insurance in the event of an accident. At Boston Direct Health, we want to keep you healthy so that you don’t need to use your health insurance for your healthcare.

Primary care Procedures

With primary care from Boston Direct Health, we provide these medical procedures, in-office, at no additional costs;
  • EKG

  • Breathing treatments for asthma attacks or bronchitis

  • Cortisone shots in the knees, shoulders and other joints

  • Stitches

  • Removal of skin tags, sebaceous cysts, and lipomas

  • Destruction of skin tags and warts with liquid nitrogen

  • Removal of excess ear wax

  • Treating ingrown toenails and infections of the nailbeds

  • Draining abscesses

  • Rapid Strep and Flu testing

  • Flu and Tetanus vaccines are provided for free (other vaccines are provided at cost).

  • Skin biopsies for unusual rashes and lesions concerning for skin cancer, while utilizing artificial intelligence through SkinIO to aid in skin cancer screening

  • Trigger point injections

  • Body composition testing

  • Antibiotics for treatment of STDs and STIs.

  • Discounted rates for blood work, heart rate monitoring (Holter monitoring), and bone density screening.

*Aesthetic and Sexual Health procedures are not included
We still recommend patients carry health insurance. The subscription to Boston Direct Health does not meet the state or federal requirements for health insurance, it does not cover any medical care provided by providers outside of Boston Direct Health such as in a hospital or another facility. We work with employer groups to provide additional healthcare benefits for their employees.

Additional Health Care Services

At Boston Direct Health, Dr. Steven Zivich believed that comprehensive preventative care is the key to long-term health. At every visit we strive to identify risk factors for diabetes, heart disease, cancer and stroke before there is a problem. Consequently, due to our direct primary care model, we are able to spend more time looking into a patient’s nutritional habits, day-to- day stressors, sleep habits, exercise and health metrics, bloodwork, additional labs, and imaging tests. Bloodwork and labs performed are customized to the needs of each patient, thorough hormone testing and vitamin testing can be performed simultaneously, as well as more extensive functional medicine labs.

As part of our primary care services, we provide the following additional health care support.

  • Preventative care

  • Working with athletes

  • Cardiometabolic management

  • Mental health

  • Hormone management, whether thyroid disorders, low testosterone, menopause to name a few.

  • Advocating on behalf of patients through our complex medical system

Advanced Healthcare for Athletes

  • Musculoskeletal evaluation of the full kinetic chain, not just referred to a specialist or given a pill for the problem.

  • Identifying the underlying joint problem after an injury and how to modify physical activity to allow for healing.

  • Access to cortisone injections when appropriate and utilizing a patient’s own growth factors to aid in healing of tendon and joint related injuries.

  • With our patients’ written consents, we communicate with their personal trainers, chiropractors, acupuncturists, physical therapists and other professionals knowing that often people need a team to treat an athlete.

  • An amazing network of Boston’s best Trainers, Acupuncturists and Chiropractors that we refer our patients to to ensure they achieve their best athletic performance.

Cardiometabolic Management

We offer support for Diabetes, high blood pressure, and assist in monitoring risk factors for heart attacks and strokes. We review dietary habits, find physical movement plans that work with our patients’ lifestyle, recommend supplements when appropriate,, and manage medications. We have an EKG in office to monitor the heart and are able to refer to outside facilities for cardiac stress testing, echocardiograms, calcium scores and additional testing.

Mental Health Monitoring

Access to mental health providers is challenging. We do not have psychiatrists on staff nor mental health counselors. However, we do work closely with our patients in the management of anxiety and depression, including management of mental health medications.

Our holistic approach to the management of stress, anxiety and depression looks at patients’ sleep patterns, nutrition, exercise, the monitoring of hormone and vitamin levels- all factors that may affect mood.
We may recommend a combination of supplements, herbs, nutritional changes, physical activity, working with therapists, acupuncturists and prescription medications to elevate your mood and relieve feelings of stress and anxiety.
Mental health greatly affects our physical health – affecting our sleep, intensifying pain, causing more digestive disturbances, negatively affecting our sexual function.

No Judgment, Complete Care

Use of Illicit Drugs and/or Anabolic Steroids: We do not recommend patients to utilize illicit drugs and the most medically safe option is to abstain and utilizing anabolic steroids can come with a multitude of side effects.
However, we want our patients to feel comfortable and safe with communicating with their medical team so that we can monitor for potential side effects and mitigate the risks as much as possible. Our medical team has a great understanding of anabolic agents such as trenbolone, oxandrolone, etc and the effects on the body. We recommend patients to not use anabolics, however if patients choose to use them we want to ensure that they are comfortable communicating to their healthcare team so that we can monitor organ function, hormone levels and try and mitigate the side effects as much as medically possible.
We do manage men with testosterone replacement therapy who are symptomatic and confirmed by laboratory levels. We do not prescribe testosterone for improved athletic performance, testosterone replacement therapy is different then taking anabolic steroids.
Accordingly, we also want our patients to feel that they can be open and feel no judgment for their recreational use of substances such as “G”, Ketamine, and Methamphetamine. We do encourage the cessation of drug use, especially due to our medical understanding of the side effects of overuse, long term use and withdrawal.
We understand that addiction is a lifelong, chronic disease. Currently, we do not prescribe methadone or suboxone for opioid addiction. We do assist patients who want to obtain sobriety guiding them to the many resources in the Boston area advocating for the medical care we all deserve while ensuring access to naloxone

Sexual Practices:

We want our patients to feel comfortable talking about their sexual preferences and sexual habits.

We provide simplified access to HIV screening and STD screening and we are able to get patients into the office for screening often on the same day as requested. We have the ability to treat patients if any test results come back as positive. View all sexual health services from Boston Direct Health.

Boston Primary Care FAQs

Read FAQs about primary care services from Boston Direct Health:
We are out of network for all health insurance companies including Medicare and Masshealth. We still work with health insurance when it comes to your prescription medications, laboratory work, imaging studies and referrals to other specialists and hospitals. Health insurance does not cover the costs of the medical care provided by Boston Direct Health. We have chosen to work directly with patients to have more control on the quality of medical care that patients deserve, oppose to working within the confines of the health insurance system.
Boston Direct Health treats patients of all ages, genders and sexual orientations.
Yes, we do require an initial screening to determine if you are an ideal candidate for our Direct Primary Care services in Boston and then a membership contract to be completed and returned with a form of payment for monthly billing. Please complete the contact form below or call (xxx) xxx-xxxx to have any additional questions answered.
Yes, HSA (Health Savings Accounts) and FSA (Flexible Savings Accounts) can be used to pay for the monthly fee for primary care services.
While we can not offer advice on tax preparation, it is not uncommon for this type of medical expense to qualify as a tax deductible expense since our patients receive medical services/visits for the monthly fee. We recommend connecting a qualified tax professional in regards to this question.

Comprehensive Primary Care in Boston

The biggest strength of Boston Direct Health’s primary care services remains the ease of communicating with your healthcare team and your Doctor.

We ensure every patient has an in-depth understanding of what is going on with their body. Boston physician Dr. Steven Zivich and staff will carefully explain your laboratory findings and imaging findings in understandable terms and provide treatment plans to help you achieve optimal health.

We provide patients with the opportunity to develop an intimate, long-term relationship with their Primary Care Provider (PCP) so that in the event of a dire medical condition, you have someone in your corner that you trust and that you can reach out to. A team of highly-experienced and caring medical professionals that will help explain what’s going on, what the next steps should be, and what options there are with any difficult medical decisions. If you reside in the Boston area, and want to experience a better healthcare process, call 617-304-1965 today to schedule your initial consultation.

How Does Functional Medicine Work? The Importance of Holistic Medicine

Sir William Osler, one of the first Physicians-in-Chief at Johns Hopkins University School of Medicine, once said that “the good physician treats the disease; the great physician treats the patient who has the disease.” Functional medicine isn’t a new concept. Its roots are derived from modern scientific medicine and functional medicine clinics are living by Osler’s words.
Functional Medicine is a systems biology-based approach that focuses on identifying and addressing the root cause of a disease. Functional medicine clinics take the holistic approach to understand who you are, knowing that every person is unique and should have a medical plan that is custom fit for their needs.
Instead of determining which drug will cure a disease, functional medicine clinics have doctors that discover why you have an ailment in the first place, and to restore what’s no longer functioning.
Think of medicine in terms of a science experiment. Experiments with limited variables are easier to find solutions for. The more complex the problem, the more difficult the solution becomes. The human body is full of variables. Lifestyle, genetic makeup, personality, and environmental factors are just a few, and within each of these basic categories are countless more variables.
Too often, traditional physicians treat the disease and not the patient. They don’t take the time–and, in their defense, can’t take the time–to understand all of the variables that make you unique. While the standard model of care works well for acute diseases, trauma, infection, and emergencies, it fails to care for the chronic diseases that affect over 133 million Americans.

Principles of Functional Medicine

According to Mind Body Green, there are five principles of functional medicine:
Everyone is different, both genetically and biochemically. With this in mind, functional medicine clinics take a personalized approach, treating the patient and not the disease. Instead of tackling the disease directly, functional medicine practitioners find ways for the body’s normal healing mechanisms to resolve the problem.
Functional medicine is science-based. There is a complex network of interconnected relationships within our body, not unlike the many webs that connect us in other ways. By understanding those relationships, functional medicine practitioners can have a deeper comprehension of the body.
The human body has the capacity of self-regulation. Your body has millions of systems that are interconnected with one another in a delicate balance. Sometimes certain conditions can knock your body off balance.
Your body can often heal itself and can prevent nearly all of the diseases of aging. Health is a state of immense vitality, not just the absence of a disease or an ailment.
Healthy active women of multiple ages laughing and walking through the park on a sunny day.

One Condition, Many Causes. One Cause, Many Conditions.

Functional medicine clinics and the doctors who run them know that one condition can have many causes. In turn, one cause can spurn many conditions. The Institute for Functional Medicine expresses that depression can be caused by a combination of multiple factors such as inflammation, an Omega-3 deficiency, a low thyroid count, and antibiotic use, to name a few. Meanwhile, inflammation can be caused by a combination depression, heart diseases, diabetes, and/or a million other things.
Functional medicine practitioners know that each symptom or differential diagnosis may be a contributing factor to an individual’s illness. By identifying and treating the root cause(s) of an illness, functional medicine has a much higher chance of properly treating the patient. Functional medicine clinics use scientific principles, advanced diagnostic testing and treatments to restore balance in a patient’s physiological processes.

Gastrointestinal Disorders Boston, MA


Gastrointestinal disorders are conditions that impact the digestive system or GI tract. A few of the most common types of GI disorders include leaky gut syndrome, lactose intolerance, food sensitivities, microbiome management, and nutritional assessment. Symptoms of digestive disorders generally include abdominal pain, bloating, nausea, vomiting, diarrhea, constipation, loss of appetite, and unintentional weight loss. GI disorders can be caused by a number of factors, including genetics, age, eating a low fiber diet, inactive lifestyle, and stress. If you suspect a GI disorder is the cause of your health problems, do not hesitate to call our office at 610-304-1965 for  assistance today. Family physician Dr. Steven Zivich can assess your concerns and build a personalized treatment plan that suits your needs.


GI disorders are often manageable with treatment, but a proper diagnosis is crucial to improve your condition. Dr. Zivich will discuss your symptoms, review your medical history, and go over any current medications you are taking. He will provide a physical exam and work with third parties for a stool analysis if needed. He can also refer patients for colonoscopies and ultrasounds. His goal is to evaluate you as a whole to help identify the underlying problem. Based on the results of your tests, he can review all your treatment options. Treatment for GI disorders is very diverse and depends on your unique concerns. Common therapies include prescription medications, enzyme supplements, nutritional counseling, and lifestyle changes.


A healthy digestive system can make the world of difference in your overall well-being. If you are experiencing GI problems, seeking help from a seasoned physician, like Dr. Steven Zivich, can help improve the function and health of your digestive tract. With personalized GI care at Boston Direct Health, your gastrointestinal disorders can be improved, easing irritable symptoms.

Dysbiosis Boston, MA


Dysbiosis is a condition that develops when the healthy bacteria (microbiota) in your digestive tract becomes imbalanced. Our GI tract consists of over 400 species of microbiota, which help fight off foreign microorganisms, assist in digestion, and help our bodies absorb essential nutrients and vitamins from our food. When our gut bacteria levels are out of wack, it can lead to a wide range of gastrointestinal issues, like diarrhea, constipation, gas, bloating, and more. Dysbiosis can be brought on by an unbalanced diet, certain medications, stress, poor dental hygiene, and excessive alcohol consumption. At Boston Direct Health, Steven Zivich, M.D. will work with you to help optimize your microbiome for optimal gut health. Do not hesitate to call our office at 610-304-1965 for directions or assistance.


Your treatment will depend on the underlying cause of your dysbiosis. First, Dr. Zivich will review your medical history, current medications, diet, and daily habits. He may also order a few diagnostic assessments, such as an organic acid test (which requires a urine sample), a comprehensive digestive stool analysis (CDSA), and a hydrogen breath test (which measures gases produced by bacteria to identify intestinal bacterial overgrowth). Depending on your test results, Dr. Zivich might suggest adjusting your medications, nutrition, stress management, vitamin supplements, and taking a pre- and probiotic to aid in balancing gut bacteria.


Does gut health affect your overall health?

Yes, it can. Research studies have found that microbial dysbiosis can be linked to several diseases and conditions, including heart disease, IBS (irritable bowel syndrome), Crohn’s disease, ulcerative colitis, obesity, autism, and more.

How common is dysbiosis?

Although precise numbers of patients with dysbiosis are difficult to quantify, because of the link between dysbiosis and so many conditions, researchers believe it is very common.

How do I know if I have dysbiosis?

The most common signs and symptoms of dysbiosis are usually digestive issues, including stomach or intestinal discomfort, chronic gas and bloating, cramping, diarrhea, and constipation.

How is dysbiosis treated?

Treating dysbiosis can encompass a number of approaches, including lifestyle and diet changes, exercising caution when using antibiotics, reducing alcohol consumption, practicing good oral hygiene, and more.


Reduce stomach cramps, chronic bloating, indigestion, and more with dysbiosis treatment. At Boston Direct Health, we emphasize a holistic approach to balancing your microbiota for optimal GI health. Do not hesitate to call our office at 617-304-1965 to schedule a virtual or in-person appointment with family physician Dr. Steven Zivich. He will take his time to listen and understand your needs to discover the best treatment solutions for you.

Chronic Fatigue Boston, MA


Chronic fatigue syndrome (CFS) is severe tiredness and low energy that lasts for at least six months and can’t be linked to a particular medical condition. It’s very difficult to diagnose, as fatigue is a symptom of many different health issues. A key identifier of CFS is that it tends to get worse with physical or mental activity but does not improve with rest. Individuals who suffer from CFS typically experience sleep that isn’t refreshing, brain fog or difficulty concentrating, poor memory, and dizziness. Chronic fatigue can make performing daily activities difficult, affecting one’s overall quality of life. Primary care physician Dr. Steven Zivich offers holistic solutions that can help dramatically improve your energy levels and mental awareness. Call Boston Direct Health in Boston, MA today.


Unfortunately, there isn’t a single test that can diagnose chronic fatigue syndrome. But, Dr. Zivich specializes in medical and functional medicine, making him an expert in diverse modalities that can aid in reducing symptoms of chronic fatigue. In many cases, certain lifestyle adjustments, stress management, vitamin supplements, and boosting gut health can help significantly reduce CFS. During your initial consultation, Dr. Zivich will review your condition with care and an attentive eye. From there, he can provide recommendations on how to improve lingering tiredness.


How many people have chronic fatigue syndrome?

Studies have estimated that as many as 2.5 million U.S. adults are affected by CFS, with women four times more likely to develop chronic fatigue syndrome.

How do I tell if I have CFS or if I’m just tired?

Chronic fatigue syndrome differs from being tired by these major symptoms of chronic fatigue:

  • Being too tired to engage in normal activities
  • Symptoms that get worse (dizziness, mental fog, sleep problems, headaches, severe exhaustion, etc.)
  • Symptoms that occur while sitting or standing
  • Memory and cognition issues

What causes chronic fatigue syndrome (CFS)?

Medical science currently doesn’t fully understand the causes of CFS. There can often be multiple causes, with one or more issues triggering chronic fatigue syndrome. CFS often runs in families and may be genetic.

Can chronic fatigue syndrome be cured?

There is currently no cure for chronic fatigue syndrome, only condition management. Some treatments for chronic fatigue syndrome include vitamin supplements, improving gut biome, lifestyle adjustments, stress management, and others.


Are you experiencing constant fatigue that limits your ability to live your daily life? Thankfully, there is hope through holistic medicine. At Boston Direct Health, family physician Dr. Steven Zivich has worked with countless individuals who are battling long-lasting fatigue and low energy levels. Contact our practice in Boston, MA to book a consultation to learn more.
Man and woman jogging down the pier looking healthy and happy.

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